Player registration for Tryouts 2016 Squad

* 1. Player Name

* 2. Phone Number

* 3. Email Address:

* 4. What is your age?

* 5. Level of Play

* 6. Current / Most Recent Team

* 7. Are you available for the May 7th and 8th Tryout, 6pm-8pm at LCHS?

* 8. List a Soccer Reference, include phone number and email address if possible.

* 9. I understand that there are risks involved with participation in the LAPFC Soccer Club WPSL soccer tryouts.

I hereby authorize the directors of Los Angeles Premier Futbol Club, Inc. ("LAPFC") to act for me according to their reasonable judgment in any emergency requiring medical attention. I hereby waive and release the directors of LAPFC from all liability and agree to accept all medical expenses incurred. I know of no physical or mental problem that will affect my ability to safely participate in these tryout sessions. I acknowledge and accept the conditions above with my click below.

I certify that I am in good health, and may participate in strenuous physical activities at the tryouts. I certify that there are no physical limitations to my participation in the tryout. Permission is granted to receive emergency medical treatment if needed. I hereby release and forever discharge LAPFC and all their agents, employees and affiliated entities from any and all liability, claims, demands, and cause of action for personal injury or death, property damage, and/or other loss suffered in connection with my participation in the tryouts. I acknowledge and accept that this Release and Waiver is intended to be binding on the family, estate, heirs, executors, administrators and assigns of the minor named above. I further acknowledge and accept that this Release and Waiver is intended to be as broad and inclusive as permitted by the laws of California and agree that if any portion of this release and Waiver is invalid, the remainder will continue to be in full force and effect. I agree that this Release and Waiver binds me to all of its terms.

I hereby grant permission to LAPFC and its legal representatives, assigns, and those acting on its behalf, to use any picture, video or audio recording of me taken in connection with the tryouts for all manner of advertising, trade, promotion, exhibition, or any other lawful purpose related to soccer whatsoever and in any form or medium.

I hereby release the LAPFC. and the California Youth Soccer Association – South, its member leagues, teams, agents, officers, coaches and players from all liability or responsibility for any claim, damage or legal action on behalf of the player or the player’s parents, heirs, or personal representatives, arising from any injury the player may sustain while participating in soccer or related activities, including transportation, except to the extent and in the amount covered by the CYSA-South accident reimbursement plan.